Abstract
Vaccination is an effective medical intervention to reduce death and morbidity caused by infectious diseases. The aim of the study was to analyse the dispensing patterns of vaccines in South Africa from a medical insurance scheme perspective. A retrospective drug utilisation study was conducted on a South African medical insurance administrator database for 2017. The database contained 3 898 535 records for medicine, medical devices and procedures. All products in ATC subgroup J07 (vaccines) were extracted and analysed. A total of 7 254 vaccines at a cost of R1 982 238.86 were dispensed in 2017 to 4 596 patients. The average age of patients was 32.57 (SD=21.67) years, with 65.62% male patients. Bacterial vaccines (J07B) accounted for 47.13% of the total number of vaccines dispensed (28.24% of cost), viral vaccines for 36.89% (44.02% of cost), and combined bacterial and viral vaccines for 15.98% (27.73% of cost). The Influenza vaccine (J07BB01) accounted for most of the vaccines dispensed (26.70%), followed by tetanus toxoid (J07AM01, 23.85%) and the diphtheria-pertussis-poliomyelitis-tetanus-hepatitis B vaccine (J07CA12, 15.00%). Three-quarters of the influenza vaccine prescriptions were dispensed during March and April 2017. The trade name vaccine that was the most commonly dispensed was TetavaxR (tetanus toxoid) single dose syringe 0.5 ml. Sixty percent of these vaccines were dispensed to patients between 30 and 49 years (mostly to male patients). The average cost claimed per vaccine was R273.26, with pneumococcus, purified polysaccharide antigen (J07AL01) on average the most expensive (R794.49). Most vaccines were dispensed by private hospitals (27.29%) and registered nurses (34.86%), with only 11.18% dispensed by pharmacies. The influenza vaccine was the most commonly dispensed, followed by tetanus toxoid. This is possibly due to medical scheme members being mostly the economically active sector of the population where workplace vaccination campaigns are often offered.
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